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Should we still ice injuries?

We have all been guided by the RICE regime for the treatment of acute joint sprains or muscle strains. Rest Ice Compression Elevation.

However recent research cautions against the overuse of ice. Research has found that the application of ice may in fact prevent the healing of an injury. The acronym RICE should possibly include a lower case “i”, RiCE, as ice is being seriously overused in the treatment of sprains and strains.

Studies have shown that there is a lack of evidence that ice promotes the healing of injuries (The American Journal of Sports Medicine 2013). Researchers caution against the use of ice to soothe inflamed injuries, as inflammation is in fact an essential part of the healing process. In an article entitled “RICE- the end of the ice age” researchers indicate that the application of ice to injured tissues causes blood vessels near the injury to constrict and shut off the blood flow that brings the healing cells of inflammation to the site. The blood vessels do not open again for many hours after the ice is applied.               

Ice has also been shown to reduce strength, speed endurance and co-ordination. Ice is often used for athletes to help them get back onto the field. Although the ice may help to reduce pain, it can subsequently reduce the athlete’s performance when they return to play. At the field side, ice should not be applied for longer than 5 minutes and should be followed by a re-warming period before returning to play.

Previously it was recommended that ice should be applied after an injury for at least 20 minutes for a period of 24 to 72 hours. This thinking has changed significantly.

However ice does still have its benefits. The application of ice has been shown to reduce pain, and so it is recommended to cool the injury for short periods soon after the injury has occurred. Ice can be applied for no more than 10 minutes, then removed for 20 minutes and the 10-minute application can be repeated once or twice. Ice does not need to be applied more than 6 hours after an injury.